Soal latihan bergaya NCLEX-PN (LPN/LVN): paket kilat

A patient's blood pressure is much higher than in all previous readings. What is the best first step?

1. AIgnore it, as it must be a machine error
2. BRecord it and give an extra dose of the blood pressure tablet
3. CRecheck it, making sure the technique and cuff size are correct
4. DTell the patient they are having a stroke

Why can a patient with a high fever be in negative fluid balance even when measured intake equals measured output?

1. AFever causes the body to make extra water from fat
2. BFever makes the kidneys produce extra urine that cannot be measured
3. CFever has no effect on the body's water balance
4. DFever increases unmeasured fluid loss through sweating and breathing

Many intensive care units bathe patients daily with chlorhexidine. What is the main purpose?

1. ATo lower the patient’s body temperature
2. BTo moisturize dry skin in older patients
3. CTo reduce skin bacteria and bloodstream infections linked to central lines
4. DTo treat existing wound infections without the need for antibiotics

A nurse has a needlestick from a patient known to have hepatitis C. Which statement about management is correct?

1. ANo follow-up is needed because hepatitis C does not spread by needles
2. BThere is no preventive drug, so baseline and follow-up testing are done to detect infection early
3. CThe hepatitis C vaccine series is started at once, with a booster dose six months later
4. DHepatitis C immune globulin is given within 24 hours, followed by a booster dose

Which patient should the RN see first after receiving a report from the night nurse?

1. ADay 2 after bowel surgery, asking to start a soft diet
2. BDay 3 after bowel surgery, wants a shower and hair wash before breakfast
3. CDay 4 after bowel surgery, waiting for discharge teaching
4. DDay 1 after bowel surgery, new chest pain and heart rate 110/min

A 2-month-old infant has a spiral fracture of the femur. The parents say the baby rolled off the sofa. What should the nurse recognize?

1. ANo further action is needed once the fracture is treated
2. BA spiral fracture in an infant is always caused by birth trauma
3. CInfants of this age often roll off furniture and break bones in this way
4. DThe injury does not fit the infant’s development, so possible abuse must be reported

A patient is prescribed two different eye drops at the same time. What is correct?

1. AGive both drops at once into the same eye
2. BGive one drop now and the other the next day
3. CWait about five minutes between the two drops
4. DMix the two drops in one bottle

A nurse teaches a patient with reflux disease. Which statement shows a need for further teaching?

1. A"I will raise the head of my bed with blocks."
2. B"I will try to lose some weight over the next months."
3. C"I will cut down on alcohol."
4. D"A big meal just before bed is fine if I take my tablet."

A patient on warfarin for atrial fibrillation has a target INR of 2,0–3,0. How does the usual target for a patient with a mechanical mitral valve compare?

1. AThe same, 2,0–3,0
2. BHigher, about 2,5–3,5
3. CMuch higher, about 5,0–6,0
4. DLower, about 1,0–1,5

A patient on digoxin has a calcium of 12,1 mg/dL (3,0 mmol/L) and new nausea and a slow pulse. Why is the calcium result important?

1. AHigh calcium only matters if the potassium is also high
2. BHigh calcium blocks digoxin, so the drug stops working
3. CHigh calcium makes the kidneys clear digoxin faster
4. DHigh calcium increases the risk of digoxin toxicity

Why are patients taking simvastatin often advised to avoid large amounts of grapefruit juice?

1. AGrapefruit inhibits CYP3A4 in the gut, raising simvastatin levels and myopathy risk
2. BGrapefruit blocks cholesterol absorption and causes low cholesterol
3. CGrapefruit makes the tablet dissolve in the mouth
4. DGrapefruit speeds up simvastatin breakdown in the liver, so the drug stops working

Mengombinasikan beberapa obat yang memperpanjang interval QT meningkatkan risiko aritmia mengancam jiwa yang mana?

1. ABlok jantung derajat satu
2. BTakikardia sinus
3. CFibrilasi atrium
4. DTorsades de pointes

A patient on nasal cannula oxygen breathes mainly through the mouth. What is the most accurate statement?

1. AIt has no effect at all in mouth breathers and must be stopped
2. BThe cannula should be placed in the mouth
3. CThe flow must be increased to 15 L/min to make it work at all
4. DIt can still work, because oxygen collects in the nasopharynx

A patient had 40 minutes of chest pain at rest. The ECG shows ST depression without ST elevation, and the troponin is rising. What is the diagnosis?

1. ANon-ST-elevation myocardial infarction
2. BStable angina
3. CAcute pericarditis
4. DST-elevation myocardial infarction (STEMI)

Before surgery for a phaeochromocytoma, why is an alpha-blocker started before any beta-blocker?

1. AThe order of the two drugs makes no difference
2. BA beta-blocker alone can cause a dangerous rise in BP
3. CBeta-blockers given first would make the tumour grow faster
4. DAlpha-blockers lower the blood glucose before surgery

A patient with a cervical spinal cord injury is helped to sit up for the first time. They become dizzy and pale, and the BP falls from 110/70 to 78/46 mmHg. What should the nurse do?

1. ALower the patient back towards lying, then raise them gradually later
2. BStand the patient up to improve the blood flow to the legs
3. CGive a large meal and a strong coffee to raise the blood pressure
4. DContinue sitting them upright, because it will pass in an hour

After a percutaneous liver biopsy, how is the patient usually positioned at first?

1. ASitting upright, with the legs over the edge of the bed
2. BOn the right side, to press on the puncture site
3. CProne, with the head lower than the feet
4. DOn the left side, to drain the liver

A patient with haematemesis becomes drowsy and starts to vomit blood again. What is the immediate priority?

1. ASend a stool sample for faecal occult blood testing
2. BTurn the patient onto their side to protect the airway
3. CGive a large glass of iced water to slow the bleeding
4. DComplete the admission paperwork and medication history

On day 1 after birth, a woman's white cell count is mildly raised and she has no symptoms. How should this be interpreted?

1. AIt proves she has an infection
2. BIt shows she is dehydrated
3. CIt can be normal soon after birth
4. DIt means she has leukaemia

A newborn boy's scrotum is empty on one side and the testis cannot be felt in the groin. What is appropriate?

1. AMassage the groin daily to push it down
2. BRecord it and arrange follow-up; many descend later
3. CTell the parents it will never descend
4. DArrange emergency surgery on the testis today

Which group of findings is typical in a teenager with severe anorexia nervosa?

1. AWeight gain, oedema and high blood pressure
2. BSlow heart rate, low blood pressure and low body temperature
3. CRapid growth, acne and an increased appetite
4. DFast heart rate, high blood pressure and a high fever

A 4-year-old chokes on a sweet but is coughing forcefully and can speak. What should the nurse do?

1. AGive back blows straight away to dislodge the sweet
2. BGive her a large drink of water to try to wash the sweet down
3. CEncourage her to keep coughing and stay with her, watching closely
4. DDo a finger sweep of the mouth to find the sweet

A newly admitted patient asks, "Do you think I'm crazy?" Which response is most therapeutic?

1. A"Of course not. Only crazy people would ask that."
2. B"Everyone here is a bit crazy in some way, so there's really nothing for you to worry about."
3. C"You seem worried about what being here means. Can you tell me more?"
4. D"Yes, but you're in the right place now."

The parent of a child recently diagnosed with autism asks, "Did his vaccines cause this?" What is the most accurate response?

1. A"Autism is caused by cold and distant parenting styles in early childhood."
2. B"Yes, the MMR vaccine is a proven cause of autism."
3. C"Large studies have found no link between vaccines and autism."
4. D"We don't know, so it is best to stop all of his other vaccines."

Latihan (nilai rekaan, bukan pedoman klinis). Suhu seorang pasien adalah 38,8 °C. Konversikan ke derajat Fahrenheit T dengan °F = °C × 9/5 + 32. Bulatkan ke satu tempat desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Selama satu shift seorang pasien mengonsumsi 6 fl oz dari jus, 1½ tbsp dari suplemen cair, 3 cangkir dari teh. Dengan ekuivalen yang diberikan, cari total asupan oral V dalam mL.

Seorang anak dengan berat 10 kg diresepkan 5 mg/kg suatu obat. Larutan stok mengandung 25 mg/mL. Tarik dosisnya: berapa volume V yang Anda berikan?

Seorang pasien memiliki tinggi 177 cm dan berat 78 kg. Resepnya 175 mg/m². Dengan rumus Mosteller BSA = √(tinggi (cm) × berat (kg)/3600), tentukan dosis D dalam mg.

Sebuah infus menetes 50 gtt/min melalui set 15 gtt/mL. Berapa mililiter V yang diterima pasien dalam 4 jam?

Infus menetes dengan laju 32 tts/menit melalui set 20 tts/mL. Tersisa 300 mL di kantong. Berapa jam t lagi hingga kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Catatan menunjukkan asupan dan haluaran seorang pasien selama satu shift 12 jam. Infus IV berjalan dengan laju yang ditunjukkan selama seluruh shift. Cari total asupan I dalam mL. Hitung serpihan es setengah volumenya.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah kantong 500 mL dijalankan dengan pompa pada 50 mL/h. Pada pukul 21:30, 300 mL sudah diinfuskan. Berapa jam t lagi sampai kantong kosong? Bulatkan ke satu angka desimal.

Latihan (nilai rekaan, bukan pedoman klinis). Sebuah bagan latihan mencatat GCS 11, dengan E3 dan V4. Berapa skor motorik M yang dicatat, dan respons mana yang digambarkannya? Berikan angkanya.

Latihan (nilai rekaan, bukan pedoman klinis). Seorang pasien latihan dinilai dengan skala jatuh Morse: riwayat jatuh dalam 3 bulan terakhir: ya; diagnosis sekunder: tidak; alat bantu jalan: tidak ada, tirah baring, atau dibantu perawat; terapi IV atau saline lock: tidak; cara berjalan: normal, tirah baring, atau kursi roda; status mental: mengetahui batas kemampuannya. Dengan batas 0–24 rendah, 25–44 sedang, dan 45 atau lebih tinggi, klik tingkat risiko jatuhnya.

1. 1risiko rendah
2. 2risiko sedang
3. 3risiko tinggi